Reconstruction of a near-total scalp avulsion with NovoSorb Biodegradable Temporizing Matrix
Case report published in Plast Reconstr Surg Glob Open (2022)
Abstract
Traumatic dog bites of the face and head are common among the pediatric population, although injuries resulting in total or subtotal scalp avulsions are rare and life-threatening. Standard treatment in these cases includes attempts at replantation or free tissue transfer; however, these procedures may not always be possible. An alternative treatment option involves the use of dermal substitutes, such as Integra (Integra LifeScience Corporation), with subsequent skin grafting. More recently, an alternative skin substitute called NovoSorb Biodegradable Temporizing Matrix (BTM) (PolyNovo North America LLC) has displayed favorable reconstructive outcomes in recent burn literature. NovoSorb BTM is a novel, fully synthetic bilayer scaffold made of biodegradable polyurethane matrix covered with a sealing membrane. In this report, the authors describe a 3-year-old boy who presented emergently with a severe dog bite avulsion to the subpericranial level of approximately 80% of his scalp, which was not replantable. The surgical plan involved a staged reconstruction using Integra and later skin grafting. Purulent infection ensued and required removal of Integra less than 2 weeks from application. Upon clearing of the infection, the wound was successfully closed with BTM and subsequent skin grafting. With proper wound management and over 6 months of follow-up, the patient experienced excellent healing of the graft with stable calvarial coverage and an acceptable aesthetic outcome. He will undergo tissue expansion of the remaining hair-bearing scalp in the future.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Near-total scalp avulsion reconstructed using NovoSorb Biodegradable Temporizing Matrix as alternative to microsurgical replantation.
Why This Matters for Hirudotherapy
This case report describes staged reconstruction of an approximately 80% scalp avulsion in a 3-year-old boy after a severe dog bite, using the fully synthetic NovoSorb Biodegradable Temporizing Matrix (BTM) followed by skin grafting after Integra failed due to purulent infection. For ASH's domain, the article is relevant only insofar as it concerns complex wound reconstruction—a clinical setting in which medicinal leeches are sometimes used adjunctively to manage venous congestion in grafted or replanted tissue. However, the abstract makes no mention of leeches or hirudotherapy at any point; the reconstructive approach relied entirely on synthetic dermal substitutes and skin grafting. This article has no direct evidence bearing on leech therapy or the leech secretome and should be considered only as background literature on reconstructive wound management.
Citation
Reconstruction of a near-total scalp avulsion with NovoSorb Biodegradable Temporizing Matrix.
Patel et al. · Plastic and reconstructive surgery. Global open, 2022
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